Genetic counseling is an important means of precaution against the birth of babies with genetic diseases, of decreasing the incidence of genetic diseases and of promoting people's innate qualities.The article explores the characteristics of those counseling,the existing problems in the process and the ethics to be observed in the course of genetic counselig.

Objective To optimize and simplify the survey method of Oncomelania hupensis snail in marshland endemic re?gion of schistosomiasis and increase the precision,efficiency and economy of the snail survey. Methods A quadrate experimen?tal field was selected as the subject of 50 m×50 m size in Chayegang marshland near Henghu farm in the Poyang Lake region and a whole?covered method was adopted to survey the snails. The simple random sampling,systematic sampling and stratified ran?dom sampling methods were applied to calculate the minimum sample size,relative sampling error and absolute sampling error. Results The minimum sample sizes of the simple random sampling,systematic sampling and stratified random sampling meth?ods were 300,300 and 225,respectively. The relative sampling errors of three methods were all less than 15%. The absolute sampling errors were 0.221 7,0.302 4 and 0.047 8,respectively. Conclusion The spatial stratified sampling with altitude as the stratum variable is an efficient approach of lower cost and higher precision for the snail survey.

Purpose To assess the clinical application of non-contrast-enhanced MR angiography (NCE-MRA) using flow sensitive dephasing (FSD) prepared steady-state free precession (SSFP) for displaying hand arteries of patients with rheumatoid arthritis. Materials and Methods Twenty-two patients with rheumatoid arthritis were recruited in this study. All the patients undertook hand NCE-MRA and three-dimensional dynamic CE-MRA on a 1.5T MR scanner. The informed consent was obtained from each subject. Image quality was assessed independently by two experienced radiologists at three arterial segments (wrist arteries, palm arteries, andfinger arteries) with a four-point scale. Signal to noise ratio (SNR), contrast to noise ratio (CNR), and vessel sharpness were evaluated by a magnetic resonance physicist. The results and image quality were statistically compared between the two MRA techniques.Results Twenty-two patients of 24 hands successfully underwent NCE-MRA and CE-MRA scan. Among 72 vascular segments, 69 segments of NCE-MRA were diagnostic, which was higher than that of CE-MRA (96% vs 83%,P<0.05). Otherwise, the image quality, SNR, CNR and vessel sharpness of NCE-MRA were all superior to those of CE-MRA (P<0.05).Conclusion NCE-MRA using FSD-prepared SSFP allows clear depiction of the hand arterial tree, and the image quality is superior to that of dynamic CE-MRA. It is a potential tool for evaluating the disease of hand arteries.

Handgrip strength asymmetry has emerged as a significant indicator of impaired muscle function, often associated with recurrent falls, cognitive decline, depression, disability, and accelerated mortality.This phenomenon has garnered clinical attention due to its detrimental effects, leading to a surge in research on handgrip strength asymmetry in recent years.However, there is currently no standardized protocol for measuring handgrip strength asymmetry across studies.Therefore, the purpose of this paper is to critically review the existing literature on handgrip strength asymmetry, with the aim of providing insights for future clinical studies and the development of measurement protocols.

Objective To understand employment directions and levels of the graduates majoring in health service management, so as to provide reference for talent cultivation and employment guidance for future graduates. Methods Collecting the data of employment directions of 244 graduates from 2014 to 2016 majoring in health service management from Nanjing Medical University and analyzing the dynamic trend of employment directions. Data were analyzed by SPSS 22.0. Results There was no significant dif-ference in the employment rate among graduates from 2014 to 2016. The proportion of female graduates choosing to do postgraduate work in mainland China was 19.7%( 34/173), higher than that of male 12.7% (9/71). The proportion of female graduates choosing directly to work was 65.3% (113/173), lower than that of male 76.1% (54/71), and the differences were statistically significant. The proportion of graduates working in upper first-class hospitals was relatively higher 39.1% (45/115), and the employment rate of that working in non-public general hospitals increased year by year. Conclusion In order to effectively ease the problem of employment imbalance, the related departments of the university should strengthen employment guidance, timely update the mentality about employment among graduates, and abandon the inherent employment orientation of large public hospitals and economically developed areas.

Objective To investigate the clinical effectiveness of foam sclerotherapy for lower extremity varicose vein with deep venous valve incompetence.Methods A retrospective study was carried out in 124 patients (185 limbs) receiving foam sclerotherapy in our department.Sixty-one limbs diagnosed as deep venous valve incompetence were categorized as the observation group,while 124 limbs without that were the control group.The main outcome were success rate,remission rate of various symptoms and signs,the scores of CEAP and CIVIQ.Results The follow up rate was 69.3％,and the follow-up period ranged from one to nine months.There was no statistical difference in the success rate between the observation group (93.4％) and control group (94.4％)(P＞0.05).However,the symptom of heaviness and oedema and the CIVIQ scores in observation group be inferior to the control group,and the difference of them were statistically significant (P＜0.05).Conclusion Deep venous valve incompetence could not decrease the success rate of foam sclerotherapy,but may influence the remission of some symptoms.It should be supplemented with medical elastic stockings or ringing of femoral veins.